April 06, 2020
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US death rates from hypertension-related CVD rose from 2007 to 2017

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Lakshmi Nambiar

In the United States, age-adjusted deaths from hypertension-related CVD increased from 2007 to 2017, with the trend accelerating starting in 2012 and the highest rate in the rural South region, according to findings presented at the virtual American College of Cardiology Scientific Session.

“Since 2011, the rate of decline from cardiovascular deaths has started to slow down,” Lakshmi Nambiar, MD, cardiovascular disease fellow at University of Vermont Larner College of Medicine, said during a consumer web briefing. “We hypothesized that hypertension-related cardiovascular death may impact recent trends in the overall rate of cardiovascular death.”

Age-adjusted death rates from hypertension-related CVD increased from 18.3 per 100,000 people (95% CI, 18.1-18.4) in 2007 to 23 per 100,000 people (95% CI, 22.9-23.2) in 2017 (P for trend < .001), Nambiar said at the web briefing.

“We found an inflection point for a rise in hypertension-related cardiovascular disease mortality in 2012, similar to the rise in heart failure-related deaths,” she said.

Compared with other regions, the rural South had an age-adjusted 2.5-fold higher death rate from hypertension-related CVD (P < .001). Nambiar noted hypertension-related CVD death was defined as CVD as the underlying cause and hypertension as a contributing cause.

The age-adjusted death rates rose 72% in rural areas and 20% in urban areas (P for trend for both < .001), according to the researchers.

During the study period, age-adjusted death rates from hypertension-related CVD rose for men and women (P for trend for both < .001), although the rates were higher for men than women (men in 2017, 25.7 per 100,000; 95% CI, 25.4-25.9; women in 2017, 20.3 per 100,000; 95% CI, 20.1-20.5).

The data were compiled using death certificates in the CDC’s WONDER database, Nambiar said.

The findings were simultaneously published in the Journal of the American College of Cardiology.

“Hypertension-related cardiovascular deaths are increasing, and those increases span all ages, both sexes, all U.S. regions and both urban and rural populations,” Nambiar said during the web briefing. “We believe that hypertension-related cardiovascular deaths are contributing to the slower decline of cardiovascular disease mortality. The striking increase that we are seeing in the rural South may be due to a number of factors, like the rise in obesity and diabetes, disparities in the social determinants of health as well as disparities in health care access and delivery to these areas. Our study reinforces the population-related importance of implementing the new hypertension guidelines when it comes to taking care of our patients.” – by Erik Swain

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References:

Nambiar L, et al. How long can a health care learning system inform CV prevention community? Presented at: American College of Cardiology Scientific Session; March 28-30, 2020 (virtual meeting).

Nambiar L, et al. J Am Coll Cardiol. 2020;doi:10.1016/j.jacc.2020.03.009.

Disclosures: The authors report no relevant financial disclosures.